Adam Misseldine, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

125081858 Issued in IL

Practice address

820 S Wood St Ste 100
Chicago, IL 60612-4325

Phone

(312) 996-2933

NPI assigned

Mar 22, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: uwj9002@direct.nyp.org
• Direct secure messaging: amisseldine150967@uihealth.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western Michigan University School of Medicine

  • Multi-Specialty Clinic/Center
  • Kalamazoo, MI
  • NPI 1316212343
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1316696693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S WOOD ST STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S WOOD ST STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-996-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISSELDINE",
        "first_name": "ADAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-22",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125081858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarthak B. Misra, M.D.
• Sudha Misra, MD
• Thani Misra, PHARM.D
• Miss Mae'S Safe Haven Homes Inc
• Jerome Nerio None Missay Soku
• Tiana Mister
• Maya Mistrik Jekot
• Neil Ashish Mistry, M.D., M.P.H.
• Joseph R. Misulonas, MD
• Paulina Anna Miszczak, M.A., NCC

• Internal Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.